Being differently abled: disability through the lens of hierarchy of binaries and Bitso-lebe-ke Seromo

Background: Despite its acceptability, the term disability has not been able to shirk the sense of incompleteness, lack, deprivation and incapacitation embodied in the prefix 'dis-'. The current wave of anti-discrimination on disability issues, calls for constant re-examination of the language and the appellations we use in respect of people with disabilities. Objectives: The aim of this study is to subject the term disability to some relevancy litmus test with a view to prevent it from acquiring Lyotard's 'grand narrative' and to propose and argue for the term 'differently abled' because of its transformative and anti-discriminatory slant. Method: The study took the form of a literature review using the optic of Derrida's hierarchy of binaries and the Sesotho proverb, 'Bitso-lebe-ke seromo', (A bad name is ominous) to explore the connotations of the term disability as a disenfranchising social construct. Results: Read through the lens of Derrida's idea of difference, disability as a concept has no inherent meaning and its meaning derives from its being differentiated from other concepts. Viewed through the lens of Bitso-lebe-ke seromo and read in the context of its deep symbolical significance, the term disability holds immense spiritual power. Conclusion: The study concludes that the term disability or disabled is exclusionary, stigmatizing, and anti-transformational. As such it embodies imperfection, incapacitation and inferiority. Not only is it ominous, it places upon people with disability the perpetual mark of unattractiveness. Against this background the term differently abled seems to convey more empowering overtones than the term disability

The impact of an inclusive education intervention on learning outcomes for girls with disabilities within a resource-poor setting

Background: Despite a global commitment to the right to education for persons with disabilities, little is known about how to achieve inclusive education in practice, particularly in low- and middle-income countries (LMICs), where the majority of the world's people with disabilities reside. Moreover, although exclusion from education is magnified by intersecting gender and socioeconomic inequalities, there is especially little knowledge regarding what approaches to inclusive education are effective amongst girls with disabilities living in resource-poor settings. Objectives: The objective of this article was to assess the impact of an inclusive education intervention led by a non-governmental organisation (NGO) on the educational attainment of girls with disabilities in the resource-poor Lakes region of Kenya. Method: A quasi-experimental design was employed, where the literacy and numeracy educational attainment of the intervention and control groups was compared over two time points a year apart (Time 1 and Time 2; total matched N = 353). During this period, activities pertaining to six core components of a holistic inclusive education model were implemented. Results: Relative to the control group, girls with disabilities in the intervention group reported a greater increase in literacy and numeracy attainment, adjusted for grade and level of functional difficulty. Conclusion: Findings suggest that the intervention was successful in engendering additional improvements in the educational attainment of girls with disabilities from the resource-poor Lakes region of Kenya. Results highlight both the applicability of NGO-led interventions in settings, where national implementation of inclusive education is constrained, and the potential of taking such interventions to scale

Representation and methods of normalisation: narratives of disability within a South African tertiary institution

Background: The manner in which disability is understood influences how individuals within a society, its institutions, policies and structures are able to accommodate and support people with disabilities (PWD) (Kaplan 2000). Understanding how students with disabilities (SWD) within a higher education context perceive and experience disability as well as how key players, namely, lecturers and disability unit (DU) staff, who influence that experience, is important in further shaping policy and providing a truly inclusive environment for all within HEIs. Objectives: The study aimed to examine the narratives of disability among SWD, lecturers and the DU within a tertiary institution, with a view to better understand their experiences and required initiatives to address the challenges of disability within a higher tertiary institution. Method: The study drew on three theoretical frameworks: social constructionism, feminist disability theory and the Foucauldian perspective. Data for the study were collected through in-depth semi-structured interviews with 12 SWD, seven members of staff from the institution's DU and five lecturers from within the School of Applied Human Sciences. Data were analysed using thematic analysis. Results: The findings suggested that in spite of both facilitating and positive representations of disability, the dominant representation of disability was perceived as challenging and as a result, disempowering. Students with disabilities were found to adapt, and consequently modify their behaviour by disassociating from their disability in order to fit in. Conclusion: The study highlights the need for creating spaces and engagement within an HEI context that both challenge negative discourses of disability, and at the same time, promote positive representations of disability

Profile and opinion of people with disability with respect to adapted physical activity participation in Ethiopia

Background: Physical activity provides long-term health benefits for everyone and it is considered to play an important role in the deterioration of health predictors, such as overweight and the associated increase in cardiovascular and all-cause mortality. Objective: To explore the profile and opinion of people with disability in Ethiopia, with respect to physical activity participation. Method: The study comprised a questionnaire survey among male and female participants (N = 334) with visual and limb impairment, aged 15­50 years, living in urban and sub-urban areas of Ethiopia. The analyses entailed descriptive frequencies and percentages, with the chi-square statistic to test for significance between subsets of data at p ≤ 0.05. Results: The profile showed participants were mostly male (n = 221, 66.2%; p ≤ 0.05), had completed secondary school (n = 204, 61.1%; p ≤ 0.05), were not formally employed with some being day-labourers (n = 92, 27.5%) and petty traders (n = 71, 21.3%). The majority (p ≤ 0.05) had limb disabilities (n = 190, 57%) as opposed to vision impairment. Only 10% (n = 34; p ≤ 0.0001) confirmed participation in physical activity. More than half (n = 175, 52.7%; p ≤ 0.0001) were unsure whether exercise improves health but the majority (n = 175, 52.4%; p ≤ 0.0001) did agree that participation in adapted physical activity requires better facilities. Conclusion: Ethiopian persons with disabilities are physically inactive. There is need to raise awareness on the benefits of physical activity amongst people with disabilities and for disability friendly facilities to encourage physical activity

Prevalence and factors of functional disability in patients with juvenile idiopathic arthritis

The aim of this study was to identify the prevalence of functional disability and the possible factors that may be associated with functional disability in children and adolescents with juvenile idiopathic arthritis (JIA) in Sharkia Governorate. Methods: This cross sectional study was carried out in Rheumatology and Rehabilitation department, Faculty of Medicine, Zagazig University Hospitals. Forty-eight consecutive patients of JIA aged from 7 to 17 years underwent assessment of socio-economic and demographic characteristics, functional ability using the childhood health assessment questionnaire (CHAQ), disease activity using the Juvenile Arthritis Disease Activity Score based on 27 joints (JADAS-27), psychological symptoms using the Children's Depression Inventory (CDI) score. Results: Multivariate modeling was applied to determine the factors that associated with functional disability. A total of 80 % of the patients (39 of 48) had functional disability. In multiple regression analyses, high CDIscores (OR 20.78, 95 % CI 1.64 to 262.91, P =.019),JADAS-27 (OR 17.49% CI 2.16 to 141.62, P =.007), low socioeconomic status (OR 10.43, 95 % CI 1.24 to 87.57, P =.031) were strong predictors of functional disability in JIA patients.Conclusion: Our study on patients with JIA provides evidence suggesting that a total of 80 % of the patients had functional disability, that is associated with higher CDI scores, higher JADAS -27 and a low socioeconomic status

Global disability burden and its predictors among adult Nigerians living with type-2 diabetes

Background: Type 2 diabetes mellitus (T2DM) is a public health issue associated with a high prevalence of disability.Studies on disability profile in terms of reduction in body structure and function, personal activities and societal participation, defined as 'global disability', are scarce among people living with T2DM in Nigeria. Objectives: To assess the prevalence of global disability and its predictors among Nigerian living with T2DM. Methods: A cross-sectional analysis of 162 patients diagnosed with T2DM and attending a tertiary health facility was performed for global disability measure and function. Their clinical and socio-demographic data were obtained. Poisson regression analysis was applied to assess the predicting factors of disability. Results: A mean global disability score of 22.1 was reported among the participants, varying from moderate to high in each item. About 25.0% had mild disability, while 60.5% reported moderate to severe disability. Elevated glycosylated haemoglobin, fasting blood glucose, systolic blood pressure, age, disease duration and marital status predicted disability. A unit increase in HbA1c, systolic blood pressure and 1 month increase in DM duration had more disability reported estimates [1.062 (CI=1.050-1.075), 1.005 (CI=1.002-1.007) and 1.001 (CI=1.000-1.002) times, respectively]. Married participants were 1.13 (CI=1.02-1.23) times more likely to be disabled than unmarried. Conclusions: There is mild to moderate burden and risk of global disability among Nigerian living with T2DM. Age, DM duration, marital status, fasting blood glucose, glycosylated haemoglobin and systolic hypertension significantly predicted disability

The prevalence pattern of locomotor disability and its impact on mobility, self-care, and interpersonal skills in rural areas of Jodhpur district

Context: Impact of disability is deleterious, affecting an individual's every aspect. Majority of disabled reside in rural areas of developing countries. Moreover, different types of disability add to its wide spectrum. All these make it a major health issue. Aims: The aim of this study was to note the prevalence rate and pattern of locomotor disability in a rural population of Jodhpur District and to observe its impact on mobility, self-care, and interpersonal skills of disabled. Settings: This study was carried out in rural field practice area of the Community and Family Medicine Department of tertiary care setup. Design: This was a cross-sectional study. Materials and Methods: House-to-house survey for a sample size of 1656 was conducted by a team of trained doctors, therapists, and anganwadi workers for identification of locomotor disability applying a pretested survey questionnaire. Statistical Analysis: SPSS version 22 was used for descriptive analysis of variables (frequency distribution), and the Chi-squared test was used for the association of sociodemographic factors with performance qualifier score. Results: The prevalence rate of 2.08% for locomotor disability (male = 57% and female = 43%) was noted, with 31% from 40 to 60 years, 49% were illiterate, and 60% were from lower class. The main etiologies were cerebrovascular accident (25%) and cerebral palsy (23%). About 80% faced some difficulties in mobility domain, 57% in self-care, and 63% in interpersonal skills. Statistically significant association was seen for self-care domain with education level (P = 0.04) and for interpersonal skill domain with age groups and diagnosis (P = 0.022 andP = 0.035, respectively). Conclusion: The overall prevalence of locomotor disability in rural Jodhpur was 2.08%, higher for males and higher from 40 to 60 years. Most disabled were illiterate and were from low socioeconomic status. Self-care, mobility, and interpersonal skills were primarily affected and require proper intervention

Reading the National Disability and Rehabilitation Policy in the light of Foucault's technologies of power

In the area of disability studies, models have been at the centre of debates, influencing social policies, practices and legal frameworks. The former Ministry of Health and Social Welfare in the Kingdom of Lesotho was not an exception. In its efforts to tackle issues of disability, it produced The National Disability and Rehabilitation Policy: Mainstreaming persons with disabilities into society in 2011. This policy document is rooted in the social model and seeks to address long-standing problems and challenges of people with disabilities in the Kingdom. Using ideas from Foucault, particularly the technologies and regimes of power, which work through language and practice, this article examined ways in which people with disabilities are constituted through state knowledge and government policies, and concluded that these constructions form the basis for alienation and marginalisation in society

The Profile of Disability Grant Applicants in Bishop Lavis; Cape Town

Background: Disability grants in South Africa increased from 600;000 in 2000 to almost 1.3 million in 2004. This rise can be attributed to the AIDS epidemic; South Africa's high rate of unemployment and possibly an increased awareness of constitutional rights. The Western Cape; which has a disability prevalence of 3.8; has also experienced an influx of applications. The study was conducted at Bishop Lavis Community Health Centre in the Cape Town Metropole; Western Cape. The primary aim of this study was to establish the profile of adults applying for disability grants at Bishop Lavis. The secondary aim was the determination of the degree of activity limitation and participation restriction by means of the ICF (International Classification of Functioning; Disability and Health) shortlist of activity and participation domains. Methods: A descriptive study was conducted with emphasis on identifying and quantifying the relevant factors. The population studied included all prospective adult (18-59 year old females and 18-64 year old males) disability grant applicants in Bishop Lavis over a two month period (April - May 2007). A structured; self-compiled questionnaire was administered during face-to-face interviews with applicants. The questionnaire included the demographic details of the applicants; disability/chronic illness/condition; educational level; social/living conditions. The second part of the questionnaire was based on the ICF shortlist of activity and participation. Results: There were 69 respondents over the period of data collection. Of the 69 applicants that participated in the study; 45 (65) received a temporary disability grant; 6 (8) a permanent grant and 18 (26) applications were rejected. The results demonstrate that most applicants are females over the age of 50; poorly educated with chronic medical conditions; living in formal accommodation with good basic services but with minimal or no disposable income. The ICF questionnaire responses showed that majority of respondents had no difficulty in most domains; except for the general tasks and demands (multiple tasks); mobility (lifting and carrying; fine hand use; walking) and domestic tasks domains which showed high percentages for severe to complete difficulty. However; further statistical analysis showed no association between degree of difficulty in the above domains and eventual outcome of type of grant received. Conclusions: This study confirms that unemployment and a lack of income are the factors influencing patients to seek assistance in the form of disability grants. Most applicants have a chronic medical condition and reported functional restrictions but only received a temporary grant. This may be an indication that most patients require further evaluation before a final decision can be made. There is a need for a standardised; objective assessment tool for disability grant applications. A campaign to educate patients about disability grants could save patients and hospital medical services time and money

Long-term Care of Children and Adolescents with Intellectual Disabilities and Severe Physical Abnormalities

Objective: This study sets out to review the clinical profile and treatment program of children and adolescents with intellectual disability in Waverley Care Center (WCC). Method: A retrospective review was done of users from January to December 2004. Reviewed parameters included age; gender; length of stay; DSM IV diagnoses; current medical treatment; and level of functioning and mobility according to the Therapeutic Classification System for Children (TCS). Results: A total of 179 users were receiving care. Although the mean age of users was 14 to 15 years; their ages ranged from 3 to 34 years. The gender ratio of users was 1 (female) to 1.6 (male). The average length of stay was 6.73 years and the range of stay from 0.5 to 29 years. Attention deficit hyperactivity disorder was diagnosed in eight children and pervasive disorders were suspected in some. Intellectual impairment ranged from severe to profound. Specific interventions with regard to severe physical impairments were made by occupational therapy and physiotherapy

The Effects of Lateral Wedge Insole in the Management of Patients with Varus Osteoarthritis of the Knee

Although insufficient evidence supports the application of lateral wedge insole (LWI) as a non-operative treatment for medial/varus osteoarthritis of the knee joint; objective evaluation of its effects on pain; stiffness and functional disability is limited. The purpose of the study therefore was to determine the effect of LWI on the functional disability and symptoms resulting from the medial/varus osteoarthritis of the knee.Fifty (50) out of 76 patients referred for physiotherapy with diagnosis of varus osteoarthritis of the knee joint participated in this study. The 50 subjects were randomly assigned into 2 groups of 25 patients each. Group A (Experimental); were treated with thermal therapy; massage and LWI. Group B (Control); were treated with thermal therapy and massage only. The outcome measures included knee pain; knee stiffness and functional disability. These parameters were statistically analysed pre and post treatment.Results established a significant difference (p0.05) post treatment between the 2 groups for the outcome measures except knee stiffness. It can be inferred from the results that the therapeutic reduction in pain intensity and enhanced physical activities in group A compared with group B was induced by the LWI.These results provide some insight into the functional effects of the LWI on pain; knee stiffness and functional disability of patients with medial osteoarthritis of the knee. This makes the LWI a useful treatment modality in the management of varus osteoarthritis/varum gonarthrosis

Noise-induced hearing loss : a suggested system for compensation in Botswana

This paper briefly describes Noise-Induced Hearing Loss (NIHL) and proposes a formula for calculation of disability from NIHL. This has been used for compensation purposes in accordance with existing laws2 with regard to disability due to hearing loss in a mine in Botswana and could be used on a national basis. Disability from Binaural Hearing Loss (BHL) is calculated by first calculating the hearing handicap for each ear; then the Binaural Hearing Loss and finally applying a formula which takes into account the compensation allowed under the law